Implementation of a fall screening protocol in a primary care setting
Date
2022
Authors
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Publisher
University of Delaware
Abstract
Objective: Research has shown that screening older adults for fall risk in primary care can help reduce injurious falls, however, many primary care providers face barriers in implementing routine fall screenings in their practice. The purpose of this quality improvement project was to implement fall screening tools recommended by Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit in a primary care setting to 1) increase the frequency of fall risk screenings in older adult patients and 2) increase the identification of fall risk among vulnerable older adults receiving well visits. ☐ Methods: Using the Model for Change to Evidence-Based Practice framework, two key elements of the STEADI toolkit were implemented over 12 weeks at a primary care setting; the Stay Independent questionnaire and the Timed Up and Go (TUG) test. Adults aged 65 or above presenting to the site for non-acute visits were screened for fall risk using the questionnaire. This project also used data from the clinical site in 2019 for comparison purposes. ☐ Results: Of the 87 patients that presented for non-acute visits, 73 were screened using the STEADI toolkit questionnaire. Of these, fourteen patients were at a high risk for falls, and eleven completed the TUG test. Five patients received high scores on the TUG. The rate of screening increased compared to 2019. However, the number of patients screened as positive did not increase. Follow-up informal discussions with clinical staff suggested positive feedback regarding fall screenings at the site. Two staff members noted time and staff was an issue when completing the TUG tests. Providers also disclosed they experienced lack of knowledge on how to treat patients for fall risk. ☐ Conclusion: Utilization of the STEADI toolkit to screen for falls did not increase identification of high fall risk patients. Staff feedback indicated that future work should focus on implementing interventions once a patient is found at risk for falls. ☐ Keywords: older adults, falls, fall prevention, fall screening, STEADI toolkit
Description
Keywords
Fall prevention, Fall screening, Falls, Older adults, STEADI toolkit